Hyderabad: Physical fitness is a thing which many people in the age group of 25 and 40 crave for. Sports, gymming and swimming are the major ways they choose to achieve physical fitness. To increase the metabolism of the body, excessive exercising is done. During this exercising or practicing any sports, the occurrence of minor injuries is very common. But, if these injuries are neglected, they might show up in the future. Major problems may arise because of the minor injuries caused while stressing the body physically. One such case has occurred in Hyderabad, which was later treated at KIMS.
Ankle, foot and knee are the most important parts of our leg which are responsible for walking, running and performing other daily activities. Small injuries in these areas are often neglected and they turn into grave issues.
Mr. Mahender (name changed), 38, is a small-time businessman in Hyderabad. He plays badminton every evening to relax from the daily business related and other tensions. Around six months ago, he slipped while playing and observed pain in the left ankle. As these are common, he ignored it, took some rest and got back to his routine. But the story didn’t end there.
Over a period of time, the pain aggravated and the frequency of occurrence has increased rapidly. He took regular pain killer pills, tried hot and cold fomentation. He even changed his footwear. But, none of them did the job. Gradually, it turned out to be so problematic that he could not attend his day to day activities too. He was in dire straits. The pain used to start in the morning and become unbearable by the evening.
Mr. Mahender went to a local doctor, who advised him to have an x-ray done to the ankle. Suspecting a ligamentous injury, he advised him an ankle wrap which worsened the condition. Then Mr. Mahender went for a second opinion. The other doctor also failed to fix the problem and he just advised a local ointment application and sufficient rest to the ankle as well as calcium and Vitamin D supplements. As the condition worsened further, Mahender had to give up badminton, which he loved very much. He even gained some weight due to lack of exercise and also got swelling in the ankle. At this point, he visited KIMS.
He was thoroughly examined with an MRI scan of the ankle, which showed a defect in the cartilage of around 18 mm x 20 mm over the left talar dome in the weight-bearing axis. This was the real reason for his pain. He couldn’t remember the exact reason for the injury too. Later. he doubted about the ankle injury which he met with long ago.
Detecting articular cartilage defects in the talus is not easy and it requires a lot of expertise and experience. Currently, two different surgeries are being done, which do not offer 100 per cent guaranteed recovery from the cartilage defect.
Dr. Suresh Babu CR, Dr. Sai Laxman Anne and Dr Ajay Kumar Paruchuri suggested a novel technique to repair cartilage defects known as the ACCR (All Autologous Cartilage Repair). This procedure involves the harvesting of healthy cartilage chips from the patient’s body, combining it with platelet rich plasma and applying it at the defect site with a sealant by drilling at the particular point.
This entire procedure is autologous as there is no usage of any synthetic chemical or foreign agent during this procedure making it completely safe for the patient, while also being a single-stage procedure (one surgery only). The ACCR is superior to other similar procedures which are either two-staged procedures, cumbersome or need a cell culture and separate scaffold to apply. This was the first of its kind surgery in Southern India.
Mr. Mahender was advised to rest for a period of three weeks and later allowed to partial weight bear. His pain, swelling and discomfort have totally reduced in the last six months since the procedure. He is more than eager to restart playing badminton.
Surgeons further explained the reasons and precautions. ”Usually, people in the age group of 25-40 will get such problems. Athletes will suffer ankle and knee injuries the most, and the problem will get sorted out by its own in this age group. But, in some cases where the injury is severe, surgical intervention may be needed. And such correction also is possible only up to the age of 50 years. Later, when arthritis develops this procedure will not show good results. Some of the sportspeople do not warm up before starting to play, don’t use proper footwear, and even if they experience minor pain, they just use painkilling sprays, or use kneecaps and other wearables to continue playing. Whenever they experience some small pains, it is always better to consult an orthopedic, take some rest and minor treatment. If the injury increases further, they have to undergo surgery. Usually, we get four to five such cases in a month,” they explained.
The surges added that one must be very careful while keeping your body fit and relaxed. Small issues may bring in major ones, which need extra care and complex treatments said the surgeons.